Borakati A, Froghi F, Bhogal RH, Mavroeidis VK. Stereotactic radiotherapy for intrahepatic cholangiocarcinoma. World J Gastrointest Oncol 2022; 14(8): 1478-1489 [PMID: 36160742 DOI: 10.4251/wjgo.v14.i8.1478]
Corresponding Author of This Article
Vasileios K Mavroeidis, MD, MSc, FRCS, FICS, MFSTEd, Surgeon, Department of Academic Surgery, The Royal Marsden NHS Foundation Trust, Fulham Road, London SW3 6JJ, United Kingdom. vasileios.mavroeidis@nhs.net
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1478-1489 Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1478
Stereotactic radiotherapy for intrahepatic cholangiocarcinoma
Aditya Borakati, Farid Froghi, Ricky H Bhogal, Vasileios K Mavroeidis
Aditya Borakati, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London E1 1FR, United Kingdom
Farid Froghi, Department of HPB and Liver Transplantation Surgery, Royal Free Hospital NHS Foundation Trust, London NW3 2QG, United Kingdom
Ricky H Bhogal, Vasileios K Mavroeidis, Department of Academic Surgery, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, United Kingdom
Author contributions: Mavroeidis VK conceptualised and designed the study; Borakati A did the literature search; Borakati A and Froghi F did the analysis, interpretation of data and drafted the original manuscript; Bhogal RH and Mavroeidis VK supervised and made critical revisions; all authors prepared the final draft and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vasileios K Mavroeidis, MD, MSc, FRCS, FICS, MFSTEd, Surgeon, Department of Academic Surgery, The Royal Marsden NHS Foundation Trust, Fulham Road, London SW3 6JJ, United Kingdom. vasileios.mavroeidis@nhs.net
Received: March 21, 2022 Peer-review started: March 21, 2022 First decision: April 25, 2022 Revised: May 7, 2022 Accepted: July 6, 2022 Article in press: July 6, 2022 Published online: August 15, 2022
Abstract
Intrahepatic cholangiocarcinoma (iCCA) is an aggressive malignancy with an increasing incidence worldwide and poor prognosis, despite several advances and continuous efforts to develop effective treatments. Complete surgical resection is the mainstay of treatment and offers a potentially curative option, but is only possible in less than a third of patients, owing to advanced disease. Chemotherapy is a well-established treatment in the adjuvant and palliative setting, however, confers limited benefit. Conventional radiotherapy is challenging due to local toxicity. With recent advances in stereotactic ablative radiotherapy (SABR), it is now possible to focus ablative beams of radiotherapy precisely aimed at tumours to minimise damage to surrounding viscera. This review details the history, technical background and application of SABR to iCCA, with directions for future research suggested.
Core Tip: Intrahepatic cholangiocarcinoma (iCCA) maintains a dismal prognosis despite best available therapy. Complete surgical resection offers a potentially curative option but is feasible in a limited number of cases. This review explores the evolving role of stereotactic ablative radiotherapy (SABR) in the management of iCCA either as an adjuvant to surgical resection, or in cases or recurrent or unresectable disease. Data on the use of SABR as a neoadjuvant/downstaging modality are scarce. Notably, published studies are limited to predominantly retrospective case series. High quality prospective trials evaluating SABR are urgently needed.
